In Mind, Body, North Koreans Still Suffer After They Defect

April 6, 2003: North Korean defectors walk to military car in Kangneung, South Korea. Photo: AFP/Donga Ilbo

SEOUL—Even those lucky defectors who survive famine, violence, and criminal gangs to escape North Korea suffer from extremely poor mental and physical health long after resettling in affluent South Korea, a new survey has shown.

The survey by a research team from Seoul National University comprised more than 200 participants. It found that many defectors suffer severe mental health problems, largely as a result of overwhelming anxiety about loved ones they left behind.

And their physical health, measured across a range of indicators, was generally worse than that of a typical South Korean hepatitis patient, it showed.

Emotional anguish

“For North Korean defectors, living in South Korea is emotionally and physically demanding,” Professor Choi Myung-Ae of Seoul National University’s College of Nursing told RFA’s Korean service.

Choi and his colleagues conducted a study across eight medical specialties and found that the general physical and mental health status of more than 200 North Korean defectors residing in South Korea scored an average of 435 points out of 800 on key indicators. This was well below the average 509 points for South Korean hepatitis patients or even 491 points for recipients of organ transplants.

More than 80 percent of respondents said they had contracted at least one disease after leaving North Korea, with an average of two to three different diseases affecting each participant. Vitamin deficiency and muscular-skeletal disease from malnutrition were frequently reported, while gastritis, arthritis, and depression were also common.

The research indicates that 20 percent of the ailments affecting North Korean defectors are mental in nature.

“The health status of defectors who left their families in the North is five times worse than that of defectors who escaped North Korea with relatives or friends,” said Park Jeong Ran, an expert on defectors at the Institute for Unification Studies at Seoul National University.

“The research indicates that 20 percent of the ailments affecting North Korean defectors are mental in nature,” she said.

Medical staff at the Hanawon reception center for defectors have indicated that around 70 percent of North Koreans in their care exhibited symptoms of depression or other stress-related syndromes.

Human trafficking, prejudice

They cite “worries over the fate of the families left behind” and “apprehension of an uncertain future in South Korea” as the main causes.

Park called for an integrated health care system for defectors, saying that the work of charities and nonprofit groups was laudable but inadequate. She also pointed to social discrimination as a major hurdle for North Koreans in the South.

The health status of defectors who left their families in the North is five times worse than that of defectors who escaped North Korea with relatives or friends.

“South Korean citizens also need to discard their bias and prejudice toward the defectors and accept them as their equals,” Park said.

The Seoul National University findings support an earlier study from a Korea University research team, which focused on diseases contracted by defectors while still in North Korea, or in third countries along their defection route to South Korea.

Along the tortuous road to defection, many North Korean women and girls fell victim to human traffickers or lived in extremely adverse conditions, and consequently were in worse health than men, that study found.

In April, the Korea Institute for Health and Social Affairs studied the health of 6,500 North Korean defectors who had arrived in South Korea between 2000 and 2005. It found a high infection rate for syphilis, at 1.8 percent in 2004 and 2.1 percent in 2005. Of 700 women aged 20 to 49 hosted by the Hanawon reception center, one out of five suffered from some type of gynecological disorder.

Kim Hye Eun, deputy secretary general of a South Korean-based North Korean defectors’ association dealing with health and employment problems, called for a more realistic health care policy to address defectors’ needs.

“If they are sick, it is not so easy to seek appropriate medical care. They have to pay for their medication out of pocket,” Kim said. “Many of them can’t go to a hospital even if they are sick, as they don’t have health insurance.”

“It takes North Korean defectors a long time to find a decent job in the South. To make things worse, they cannot afford to look after their own health, and often their health condition doesn’t allow them to continue on their jobs, thus creating a vicious circle that encompasses both health and employment issues,” she said.

Rampant post-traumatic stress disorder

She said the health care problem was more urgent than financial incentives to retrain for employment in the South.

“Ideally, North Korean defectors in the South should receive lifelong free health insurance, or at the very least be granted an extension of their current two-year free health insurance coverage,” Kim said.

A 2001 study of post-traumatic stress disorder among defectors found that they reported certain traumatic events in North Korea with a high frequency.

Most commonly reported were: “witnessing public executions,” followed by “hearing news of the death of a family member or relative due to starvation,” “witnessing a beating,” “witnessing a punishment for political misconduct,” and “death of a family member or relative due to illness.”

The study, published in the international medical journal
The Lancet
, found symptoms of post-traumatic stress disorder (PTSD) in 29.5 percent of North Koreans in South Korea, compared with a rate of 56 percent found among North Koreans in China in a separate study.

Women are also thought to have experienced far higher rates of rape and sexual assault, often through being trafficked by criminal gangs, than were reported in the
Lancet
study, however.

Original reporting in Korean by Youngyoon Choi and Naeri Kim. RFA Korean service director: Jaehoon Ahn. Translated from Korean by Grigore Scarlatoiu. Written for the Web in English by Luisetta Mudie and edited by Sarah Jackson-Han.